Well, my birthplace of Kingston upon Hull in the United Kingdom has for 30 years been officially twinned with Freetown, the capital of Sierra Leone, the aim being to promote cultural understanding and friendships. Despite this long-established link I, and others in Hull, knew nothing about the women trying to survive in our twin city. My first visit to Sierra Leone came in February 2007 to facilitate a photography exchange project that I had founded for women of our twin cities. A visual conversation if you like, sharing our lives through imagery and learning about each other.

I hoped at least 10 women in Freetown would sign up for a series of classes in digital photography skills in order to make the project work. Around 55 women signed up. I was shocked. Women were (and still are) crying out for new skills, new learning, new ANYTHING, that would lift them out of poverty and give them hope for the future. I have travelled to many so-called ‘developing’ countries but never have I seen such poverty, such a hunger for a better life, as I did that February in Sierra Leone. Appalled at the low status of these women, the struggles they face daily, and the conditions in which many of them live, I was also struck by their spirit, resilience and determination and desire to be part of a world of equality and opportunity. There IS hope here, and lots of it and I try to photograph this and show it in the evolving body of work that is‘42′.

Is it as important to photograph hope as well as despair? I think yes, because hope draws a crowd and in turn, support. I see the way Amnesty and its partners have used some of the images from 42 to show that they ”believe the world’s women – and its children – deserve better”. I’ve also been encouraged by viewers of ’42’ who are keen to help these women, or who feel compelled to learn more.

Maternal mortality is a big killer in Sierra Leone, and so my projectencompasses the stories of women like Isatu, who I had begun to photograph, and who bled to death during pregnancy, aged just 35. Women like Julie, who I followed as she searched the cemetery in Freetown, Sierra Leone, for the grave of her daughter Sylvia who died aged 23 a year ago, following complications in pregnancy. Women like Gladys, who carried a baby the full term, only to give birth to Lewis, a son who lived for just an hour. Young women, like Francess, Cecilia and Admire, who have yet to have children. Young women who fear becoming pregnant.

Maternal mortality is high, but I also want to use this blog to report that the women in Sierra Leone tell me deaths from cervical cancer and breast cancer are also high. On my recent visit, Admire explained how she had found a lump in her breast and went to the doctor who gave her cream (at a cost) to rub on the lump. She is just 20. Will she be there when I return this summer? That is my hope.

Lee Karen Stow is a freelance photojournalist and writer. Her recent project ‘42’is a photographic documentary and written study paying tribute to the women of Sierra Leone, West Africa.

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This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant T76MC00001 and entitled Training Grant in Maternal and Child Health. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.